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EFFECT OF EATING MULTANI MATI ON MOUTH HEALTH

NAME:________________________________________________________ GENDER:________________________ QUALIFICATION:_____________________ DESIGNATION:_____________________ Q1. Are you eating multani mitti ?? 1.yes 2.no Q2.Why are eating multani maati ?? (___________________________) Q3.What is taste of multani mitti? (____________________) Q4.Is your mom or sister eating multani mitti ? 1.yes 2.no Q5.Do you know that worms inside you is due to eating of multani matti ? 1.yes 2.no Q6. Why dont you know about upper mention fact ? (________________________________)(mention reason) Q7.After eating of multani mitti , you take water? 1.yes 2.no Q8.On which time do you eat multani mitti ? 1.before lunch 2.after lunch 3. as your wish Q9.Are you taking multani mitti during pregnancy? 1.yes 2.no Q10.why are eating multani mitti during pregnancy????????

Mention reason(_______________________) Q11.Is your husband prohibit you to eat multani matti ? 1.yes 2.no Q12.Is this servey has any worth ? 1.yes 2.no Q13.what do you think about this survey?

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